Association between cerebral tissue oxygen saturation and neurodevelopmental delay in patients undergoing pediatric liver transplantation

Abstract

Purpose Pediatric liver transplantation is considered the most effective treatment option for congenital biliary atresia. In recent years, researchers have focused on the long-term neurological developmental status of patients. Identifying the risk factors associated with perioperative neurological dysfunction in patients undergoing pediatric liver transplantation have emerged as crucial issues. This study aimed to explore the association between cerebral tissue oxygen saturation (SctO2) and neurodevelopmental delay in patients undergoing pediatric liver transplantation. Methods This observational study was conducted between September 2019 and September 2021. The primary outcome of this study was neurodevelopmental delay 1 year after pediatric liver transplantation. The secondary outcomes included prolonged intensive care unit (ICU) stay and hospitalization. The univariate and multivariate logistic regression analyses were performed to explore the risk factors for neurodevelopmental delay using the Ages Stages Questionnaires scale. Additionally, the risk factors for the prolonged length of stay in the ICU and hospital were also analyzed. Results 123 patients were included in the statistical analysis. The preoperative weight had a significant impact on postoperative neurological development. The intraoperative maximum SctO2 (P = 0.037, OR = 0.951, 95% CI: 0.904–0.997) had a significant influence on the developmental delay in communication skills. The risk factors for the delay in problem-solving skills were intraoperative maximum SctO2 (P = 0.034, OR = 0.901, 95% CI: 0.807–0.981) and age (P = 0.026, OR = 0.501, 95% CI: 0.251–0.861). Conclusions This prospective observational study found an association between the decline of SctO2 and developmental delay in communication and problem-solving following pediatric liver transplantation. Hence, an evaluation of SctO2 might guide the intraoperative anesthesia strategy and improve the long-term prognosis of patients.